Alabama state law does not require the teaching of sexuality education, however, a resolution adopted by the Board of Education in 1987 does require that students in grades five through 12 receive instruction about AIDS through a health education program. Should schools choose to offer additional sexuality education, the Code of Alabama sets minimum requirements for what must be taught, but specific content is developed locally. Among other things, the code requires sex education classes to tell students that:

abstinence from sexual intercourse outside of lawful marriage is the expected social standard for unmarried school-age persons.[2]

The Code also states that:

course materials and instruction that relate to sexual education or sexually transmitted diseases should be age-appropriate;

course materials and instruction that relate to sexual education or sexually transmitted diseases should emphasize the importance of self-control and ethical conduct pertaining to sexual behavior;

statistics used must be based on the latest medical information that indicate the degree of reliability and unreliability of various forms of contraception, while also emphasizing the increase in protection against pregnancy and protection against sexually transmitted diseases, including HIV and AIDS infection, which is afforded by the use of various contraceptive measures; and

classes must emphasize, in a factual manner and from a public health perspective, that homosexuality is not a lifestyle acceptable to the general public and that homosexual conduct is a criminal offense under the laws of the state.[3]

In addition to this code, the AlabamaCourse of Study: Health Education provides the foundation for the minimum content requirements for topics such as HIV, STDs, and pregnancy prevention. The sexuality topics covered include “societal expectations of remaining abstinent until married,” the “physical, social, and emotional effects” of STDs, disease transmission, responsible decision-making, and refusal skills, among others.[4]

Parents or guardians may remove their children from sexuality education and/or STD/HIV education classes. This is referred to as an “opt-out” policy.

SeeAlabama State Code Section 16-40A-2, the Alabama Course of Study: Health Education, and the Resolution to Provide Information to Students to Prevent the Spread of Acquired Immune Deficiency Syndrome Disease in the Public Schools of Alabama.

In 2009, 51% of female high school students and 62% of male high school students in Alabama reported ever having had sexual intercourse compared to 46% of female high school students and 46% of male high school students nationwide.

In 2009, 4% of female high school students and 16% of male high school students in Alabama reported having had sexual intercourse before age 13 compared to 3% of female high school students and 8% of male high school students nationwide.

In 2009, 14% of female high school students and 26% of male high school students in Alabama reported having had four or more lifetime sexual partners compared to 11% of female high school students and 16% of male high school students nationwide.

In 2009, 42% of female high school students and 41% of male high school students in Alabama reported being currently sexually active (defined as having had sexual intercourse in the three months prior to the survey) compared to 36% of female high school students and 33% of male high school students nationwide.

In 2009, among those high school students who reported being currently sexually active, 55% of females and 63% of males in Alabama reported having used condoms the last time they had sexual intercourse compared to 54% of females and 69% of males nationwide.

In 2009, among those high school students who reported being currently sexually active, 25% of females and 17% of males in Alabama reported having used birth control pills the last time they had sexual intercourse compared to 23% of females and 17% of males nationwide.

In 2009, among those high school students who reported being currently sexually active, 15% of females and 28% of males in Alabama reported having used alcohol or drugs the last time they had sexual intercourse compared to 17% of females and 26% of males nationwide.

In 2009, 85% of high school students in Alabama reported having been taught about AIDS/HIV in school compared to 87% of high school students nationwide.

Teen Pregnancy, Birth, and Abortion

Alabama’s teen birth rate ranks 12th in the United States, with a rate of 53 births per 1,000 young women ages 15–19 compared to the national rate of 41.5 births per 1,000.[6] In 2008, there were a total of 7,117 live births reported to young women ages 15–19 in Alabama.[7]

In 2005, Alabama’s teen pregnancy rate ranked 17th in the United States, with a rate of 73 pregnancies per 1,000 young women ages 15–19 compared to the national rate of 70 pregnancies per 1,000.[8] There were a total of 11,430 pregnancies among young women ages 15–19 in Alabama.[9]

In 2005, Alabama’s teen abortion rate ranked 30th in the United States, with a rate of 12 abortions per 1,000 young women ages 15–19 compared to the national rate of 19 abortions per 1,000.[10]

Alabama ranks 14th in cases of HIV infection diagnosed in the United States among all age groups. In 2008, there were a total of 820 new cases of HIV infection diagnosed in Alabama.[12]

Alabama’s HIV infection rate ranks 12th in the United States, with a rate of 17.6 cases per 100,000 individuals compared to the national rate of 19.5 cases per 100,000.[13]

Alabama’s HIV infection rate among young people ages 13–19 ranks 6th in the United States, with a rate of 11.1 cases per 100,000 young people compared to the national rate of 9.1 cases per 100,000.[14]

Alabama ranks 20th in number of reported AIDS cases in the United States among all age groups. In 2008, there were a total of 406 new AIDS cases reported in Alabama.[15]

Alabama’s AIDS rate ranks 21st in the United States, with a rate of 8.7 cases per 100,000 individuals compared to the national rate of 12.3 cases per 100,000.[16]

Alabama’s AIDS rate among young people ages 13–19 ranks 23rd in the United States, with a rate of 1.3 cases per 100,000 young people compared to the national rate of 1.8 cases per 100,000.[17]

Sexually Transmitted Diseases

Alabamaranks 4th in reported cases of Chlamydia among young people ages 15–19 in the United States, with an infection rate of 27.98 cases per 1,000 compared to the national rate of 19.51 cases per 1,000. In 2008, there were a total of 9,133 cases of Chlamydia reported among young people ages 15–19 in Alabama.[18]

Alabamaranks 4th in reported cases of gonorrhea among young people ages 15–19 in the United States, with an infection rate of 9.10 cases per 1,000 compared to the national rate of 4.52 cases per 1,000. In 2008, there were a total of 2,972 cases of gonorrhea reported among young people ages 15–19 in Alabama.[19]

Alabamaranks 4th in reported cases of primary and secondary syphilis among young people ages 15–19 in the United States, with an infection rate of 0.08 cases per 1,000 compared to the national rate of 0.04 cases per 1,000. In 2008, there were a total of 26 cases of syphilis reported among young people ages 15–19 in Alabama.[20]

The President’s Teen Pregnancy Prevention Initiative (TPPI) funds medically accurate and age-appropriate programs to reduce teen pregnancy. The U.S. Department of Health and Human Services, Office of Adolescent Health (OAH) administers the grant program, which totaled $110 million in discretionary funding for Fiscal Year 2010. TPPI consists of two funding tiers that provide grants to local public and private entities. Tier 1 totals $75 million and provides funding for the replication of evidence-based programs proven to prevent unintended teen pregnancy and address underlying behavioral risk factors. Tier 2 totals $25 million and provides funding to develop and test additional models and innovative strategies. A portion of the Tier 2 funds, $15.2 million, was allocated for research and demonstration grants to test innovative approaches, while the remaining funding, $9.8 million, was allocated for grants to support communitywide initiatives. TPPI also dedicates $4.5 million in funding to conduct evaluations of individual programs.

There is one TPPI Tier 1 grantee in Alabama, Macon County Board of Education, which received $426,172 for Fiscal Year 2010.

Macon County Board of Education, $426,172 (2010−2014)

The Macon County Board of Education (MCBOE) is a Tier 1 grantee located in Tuskegee, Alabama. MCBOE oversees the Macon County School District, which consists of seven schools (Booker T. Washington High School, D.C. Wolfe Elementary School, George Washington Carver Elementary School, Lewis Adams Early Childhood Center, Notasulga High School, Tuskegee Institute Middle School, and Tuskegee Public Elementary School), serving nearly 2,800 PK–12 students.[21] The school district is using its funds to implement Teen Outreach Program, a youth development curriculum with a sexuality education component, and Making a Difference!, an abstinence-based youth development curriculum. MCBOE implements Teen Outreach Program in three schools, Booker T. Washington High School, Notasulga High School, and Tuskegee Institute Middle School, and at two community-based organizations, the Tuskegee Area Health Education Center and the Tuskegee-Macon County YMCA. The program serves African-American youth ages 12–18. The Making a Difference! Program will target African-American students ages 11–13 at D.C. Wolfe Elementary School, Tuskegee Institute Middle School, and Notasulga High School.

Teen Outreach Program (TOP) is an evidence-based youth development program that engages young people in experiential learning activities in order to “prepare for successful adulthood and avoid problem behaviors.”[22] The program is designed for youth ages 12–17 and focuses on reducing rates of school failure, school suspension, and teen pregnancy. TOP consists of a nine-month curriculum that addresses such topics as relationships, peer pressure, decision making, values clarification, goal-setting, adolescent development, and sexual health.[23] It also includes a 20-hour community service component that engages participants in activities to enhance knowledge and develop skills, including self-efficacy, communication, conflict-management, and self-regulation. TOP can be administered as an in-school, after-school, or community-based program. The program is proven effective in preventing teen pregnancy and increasing academic success among participants. An evaluation of the program published in Child Development found that young women, ages 15–19, who participated in TOP were significantly less likely to report a pregnancy during the program than participants in the control group.[24]

Making a Difference! is an evidence-based pregnancy-, STD-, and HIV-prevention education curriculum that emphasizes abstinence from sexual activity. Adapted from the evidence-based curriculum, Be Proud! Be Responsible!, Making a Difference! aims to increase participants’ knowledge about HIV/STD and pregnancy prevention as well as their confidence to negotiate sexual pressure and intention to abstain from sex. It is designed for use with African-American, Latino, and white adolescents ages 11–13 and can be implemented in school- or community-based settings. The curriculumincludes interactive activities, small group discussions, and skill-building exercises, including role-plays, aimed to increase comfort and efficacy with practicing abstinence. An evaluation of the curriculum published in the Journal of American Medical Association found, at a three-month follow-up, that participants in the program were less likely to report having had sexual intercourse in the three months prior than peers in the control group. Findings also show that the program helped to delay sexual initiation among program participants who were sexually inexperienced.[25]

MCBOE partners with the Macon County Department of Human Resources (DHR), the Macon County Health Department, Tuskegee Area Health Education Center, and the Tuskegee-Macon County YMCA in implementation. The Macon County DHR and the Health Department will provide participants with related health care, such as family planning and STD testing.[26] Participants will also have access to other social services, such as the JOBS Program, a welfare-to-work initiative established by the Alabama DHR.[27] MCBOE plans to reach approximately 600 youth annually with its TPPI program.

TPPI Tier 2: Innovative Approaches

The TPPI Tier 2 grant program supports research and demonstration programs in order to develop, replicate, refine, and test additional models and innovative strategies for preventing teenage pregnancy.

There are no TPPI Tier 2 Innovative Approaches grantees in Alabama.

TPPI Tier 2: Communitywide Initiatives

The TPPI Tier 2 grant program also supports communitywide initiatives to reduce rates of teenage pregnancy and births in communities with the highest rates. The program awards grants to national organizations as well as state- and community-based organizations. Funded national partners provide training and technical assistance to local grantees. The Centers for Disease Control and Prevention (CDC) administer the grant program in partnership with OAH.

There are no TPPI Tier 2 Communitywide Initiatives grantees in Alabama.

The Personal Responsibility Education Program (PREP) totals $75 million per year for Fiscal Years 2010−2014 and is the first-ever dedicated funding stream for more comprehensive approaches to sexuality education. The U.S. Department of Health and Human Services, Administration for Children and Families (ACF) administers the grant. PREP includes a $55 million state-grant program, $10 million to fund local entities through the Personal Responsibility Education Innovative Strategies (PREIS) Program, $3.5 million for Indian tribes and tribal organizations, and $6.5 million for evaluation, training, and technical assistance. Details on the state-grant program and PREIS are included below. At the time of publication, the funding for tribes and tribal organizations had not yet been awarded.

PREP State-Grant Program

The PREP state-grant program supports evidence-based programs that provide young people with medically accurate and age-appropriate information for the prevention of unintended pregnancy, HIV/AIDS, and other sexually transmitted infections (STIs). The grant program totals $55 million per year and allocates funding to individual states. The grant does not require states to provide matching funds. Funded programs must discuss abstinence and contraception, and place substantial emphasis on both. Programs must also address at least three of the following adulthood preparation subjects: healthy relationships, positive adolescent development, financial literacy, parent-child communication skills, education and employment skills, and healthy life skills.

The Alabama Department of Public Health received $789,678 in federal PREP funds for Fiscal Year 2010.

The department has issued an application announcement for available funds under the state’s PREP grant program. At the time of publication, sub-grantees had not yet been determined.

The Alabama PREP state-grant program will serve youth ages 15–19 in community-based settings. The program will use Reducing the Risk and six sessions of Love U2 Relationship Smarts to participants. Alabama PREP will address the following adulthood preparation subjects: healthy relationships, including parent-child communication; adolescent development; and healthy life skills.

Reducing the Risk: Building Skills to Prevent Pregnancy, STD and HIV is an evidence-based, sexuality education curriculum designed for classroom use with students in the ninth and tenth grades. It is appropriate for use with multi-ethnic populations.[28]Reducing the Risk aims to reduce high-risk behaviors among participants and emphasizes strategies for abstaining from sex or practicing safer sex. The 16-lesson curriculum addresses both abstinence and contraception use and includes experiential activities that teach students to develop refusal, negotiation, and communication skills. An evaluation of the program published in Family Planning Perspectives found that it increased parent-child communication, especially among Latino youth, delayed the initiation of sexual intercourse, and reduced incidence of unprotected sex among lower-risk youth who participated in the program.[29]

Love U2 Relationship Smarts is part of the Love U2 abstinence-only-until-marriage curricula series that also includes Love U2 Dating Smarts, Love U2 Baby Smarts, Love U2 Communication Smarts, and Love U2 Becoming Sex Smart. It is described as a “series of units that help young people acquire practical skills for emotionally healthy and ethically sound relationships.”[30] The curricula series is produced and distributed by The Dibble Institute for Marriage Education, a non-profit organization based in Berkeley, California that focuses on “teaching young people healthy romantic relationship skills.”[31]

Love U2 Relationship Smarts is designed for students in grades nine–12 and includes information and skill-building activities to impart youth with the “knowledge necessary for making wise relationship choices.”[32] The 13-lesson curriculum addresses such topics as, maturity, values clarification, peer pressure, attractions and infatuation, principles of smart relationships, and “the nature of true intimacy,” among others.[33] The curriculum also focuses on preventing dating violence as well as communication and conflict resolution skills. Love U2 Relationship Smarts aims to motivate teens “to make wiser relationship and sexual choices by examining the consequences of early and unwed pregnancy...” It addresses such issues as the role of fathers, the needs of children as they relate to pregnancy prevention and the importance of remaining abstinent, cohabitation, the benefits of marriage, research findings on partner selection, and marital successes and failures.”[34] The curriculum is currently being evaluated as part of a large-scale study conducted by Auburn University, and supported by a federal, five-year Healthy Marriage Initiative demonstration grant (Fiscal Years 2005–2010).

The Alabama Department of Public Health has issued a Request for Proposal for available PREP funds. Community-based organizations, including local health departments, from the following counties were eligible to apply: Bibb, Calhoun, Chilton, Cleburne, Colbert, Coosa, Covington, Cullman, Dallas, Etowah, Franklin, Greene, Jackson, Jefferson, Lamar, Lawrence, Lowndes, Marshall, Montgomery, Perry, Pickens, Sumter, Talladega, Tallapoosa, Tuscaloosa, and Walker. At the time of publication, proposals for funding had not yet been approved.[35]

Personal Responsibility Education Innovative Strategies (PREIS)

The PREIS Program supports research and demonstration programs to develop, replicate, refine, and test innovative models for preventing unintended teen pregnancy. ACF administers the grant program in collaboration with OAH and provides a total of $10 million in funding directly to local public and private entities.

The Title V State Abstinence Education Grant Program (Title V Abstinence-Only Program) allocates $50 million per year to states for Fiscal Years 2010−2014. ACF administers the grant program. The Title V Abstinence-Only Program requires states to provide three state-raised dollars or the equivalent in services for every four federal dollars received. The state match may be provided in part or in full by local groups. All programs funded by the Title V Abstinence-Only Program must promote abstinence from sexual activity as their exclusive purpose and may provide mentoring, counseling, and adult supervision toward this end. Programs must be medically accurate and age-appropriate and must ensure abstinence is an expected outcome.

The Alabama Department of Public Health received $867,552 in federal Title V abstinence-only funding for Fiscal Year 2010.

The department provides sub-grants to five local public and private entities: Alabama Cooperative Extension Service; AIM Project; Auburn University; Circle of Care; and Crittenton Youth Services.

In Alabama, the match will be provided through in-kind funds.

The state’s Title V abstinence-only program provides instruction to sixth and seventh grade students in school- and community-based settings and also provides outreach to youth ages 12–18 and their parents. Through the program, local entities will administer the Managing Pressures before Marriage(MPM) curriculum to students in grades six and seven. The curriculum, Media Madness, will be offered to youth in other grades and their parents. In addition, the Alabama Department of Public Health will administer a project-wide program on STDs. Programming will be provided upon request to school districts in the following counties: Barbour, Bullock, Butler, Chambers, Choctaw, Coffee, Conecuh, Crenshaw, Dale, Dallas, DeKalb, Elmore, Escambia, Hale, Lee, Marengo, Marion, Mobile, Monroe, Pike, Russell, Tuscaloosa, and Wilcox. The state director for the Department of Public Health will determine what program is used and assure the medical accuracy of all curriculum materials.

Managing Pressures before Marriage is an abstinence-only-until-marriage curriculum adapted from Postponing Sexual Involvement, a peer education human sexuality curriculum.[36] Produced by the Jane Fonda Center at Emory University, the curriculum includes five, one-hour lessons that address the potential negative consequences of early sexual activity. The curriculum discusses the influence of the media and peer pressure on early sexual involvement and provides students with skill-building exercises in order to combat these pressures. A program enhancement includes homework assignments for students to complete with their parents, which are designed to increase parent-child communication.[37]

Managing Pressures before Marriage is designed to meet all eight points of the federal definition for “abstinence education,” which teaches, among other concepts, that abstinence from sexual activity outside of marriage is “the expected standard for all school-age children;” “that a mutually faithful monogamous relationship in the context of marriage is the expected standard of sexual activity;” and that “sexual activity outside the context of marriage is likely to have harmful consequences for the child, the child’s parents, and society.”[38]

Also produced by the Jane Fonda Center, Media Madness is a media literacy and health education intervention for teens. The curriculum aims to help young people critically evaluate the purpose of the media and its influence on sexual behavior. Skill-building exercises encourage teens to examine their own beliefs and values, set limits for sexual expression, and to resist media and peer pressure.[39]

SIECUS is not aware of any examples of model programs, policies, or best practices being implemented in Alabama public schools that provide a more comprehensive approach to sex education for young people.

We encourage you to submit any updated or additional information on comprehensive approaches to sex education being implemented in Alabama public schools for inclusion in future publications of the SIECUS StateProfiles. Please visit SIECUS’ “Contact Us” webpage at www.siecus.org to share information. Select “state policy” as the subject heading.

[1] This refers to the federal government’s fiscal year, which begins on October 1st and ends on September 30th. The fiscal year is designated by the calendar year in which it ends; for example, Fiscal Year 2010 began on October 1, 2009 and ended on September 30, 2010.

[3]Ala Code § 16-40A-2(b); Ala. Code §§ 16-40A-2(c)(1)–(2), (8). Regarding the provision that students must be informed that homosexual conduct is a criminal offense, the United States Supreme Court handed down a decision inLawrence v. Texas that declared state laws criminalizing homosexual behavior to be unconstitutional in 2003, <http://www.legislature.state.al.us/CodeofAlabama/1975/16-40A-2.htm>.

[10]U.S. Teenage Pregnancies, Births, and Abortions: National and State Trends and Trends by Race and Ethnicity, Table 3.3

[11] This section provides data from 2008, the most recent year for which the CDC has reported HIV/AIDS data for young people ages 13–19. For this reason, all the data presented is from 2008 for the purposes of direct comparison.

[18] “Wonder Database: Selected STDs by Age, Race/Ethnicity, and Gender, 1996-2008 Results,” (Atlanta, GA: Centers for Disease Control and Prevention, 30 June 2009), accessed 5 March 2010, <http://wonder.cdc.gov/>; see also Table 10: “Chlamydia: Reported Cases and Rates Per 100,000 Population by Age Group and Sex: United States, 2004–2008,” Sexually Transmitted Disease Surveillance 2008, (Atlanta, GA: Centers for Disease Control and Prevention, Division of STD Prevention, November 2009), accessed 5 March 2010, <http://www.cdc.gov/std/stats08/surv2008-Complete.pdf>, 95.

[19] Ibid; see also Table 20: “Gonorrhea—Reported Cases and Rates per 100,000 Population by Age Group and Sex: United States, 2004–2008,” Sexually Transmitted Disease Surveillance 2008,106.

[20] Ibid; see also Table 33: “Primary and Secondary Syphilis—Reported Cases and Rates per 100,000 Population by Age Group and Sex: United States, 2004–2008,” Sexually Transmitted Disease Surveillance 2008, 121.